Methods, systems, and devices relating to surgical end effectors

ABSTRACT

The embodiments disclosed herein relate to various medical device components, including components that can be incorporated into robotic and/or in vivo medical devices, and more specifically including end effectors that can be incorporated into such devices. Certain end effector embodiments include various vessel cautery devices that have rotational movement as well as cautery and cutting functions while maintaining a relatively compact structure. Other end effector embodiments include various end effector devices that have more than one end effector.

CROSS-REFERENCE TO RELATED APPLICATION(S)

This application claims priority as a continuation application to U.S.application Ser. No. 16/512,510, filed on Jul. 16, 2019 and entitled“Methods, Systems, and Devices Relating to Surgical End Effectors,”which claims priority as a continuation application to U.S. applicationSer. No. 15/700,713, filed on Sep. 11, 2017 and entitled “Methods,Systems, and Devices Relating to Surgical End Effectors,” which issuedas U.S. Pat. No. 10,350,000 on Jul. 16, 2019, which claims priority as acontinuation application to U.S. application Ser. No. 14/745,587, filedon Jun. 22, 2015 and entitled “Methods, Systems, and Devices Relating toSurgical End Effectors,” which issued as U.S. Pat. No. 9,757,187 on Sep.12, 2017, which claims priority as a continuation application to U.S.Pat. No. 9,060,781, issued on Jun. 23, 2015 and entitled “Methods,Systems, and Devices Relating to Surgical End Effectors,” which claimspriority to U.S. Provisional Patent Application 61/495,487, filed Jun.10, 2011 and entitled “Vessel Sealing Device for Robotic Devices,” andto U.S. Provisional Patent Application 61/498,919, filed Jun. 20, 2011and entitled “Dual End Effector Components and Related Devices, Systems,and Methods,” all of which are hereby incorporated herein by referencein their entireties.

GOVERNMENT SUPPORT

This invention was made with government support under Grant No.W81XWH-09-2-0185, awarded by the Telemedicine and Advanced TechnologyResearch Center within the Department of Defense and Grant No.NNX09A071A, awarded by the National Aeronautics and Space AdministrationExperimental Program to Stimulate Competitive Research. The governmenthas certain rights in the invention.

FIELD OF THE INVENTION

The embodiments disclosed herein relate to various medical devicecomponents and related components, including robotic and/or in vivomedical devices and related components. More specifically, certainembodiments include various medical device attachment and controlcomponents, often referred to as “end effectors” or “operationalcomponents.” Certain end effector embodiments disclosed herein includevessel sealing and cutting devices, and, in particular, bipolar cauterydevices having integrated cutting components. Other end effectorembodiments disclosed herein include various dual end effectorcomponents, wherein such components have two or more end effectors.Further embodiments relate to systems and methods for operating theabove components.

BACKGROUND OF THE INVENTION

Invasive surgical procedures are essential for addressing variousmedical conditions. When possible, minimally invasive procedures, suchas laparoscopy, are preferred.

However, known minimally invasive technologies such as laparoscopy arelimited in scope and complexity due in part to the need to remove andinsert new surgical tools into the body cavity when changing surgicalinstruments due to the size of access ports. Known robotic systems suchas the da Vinci® Surgical System (available from Intuitive Surgical,Inc., located in Sunnyvale, Calif.) are also restricted by the accessports, the necessity for medical professionals to remove and insert newsurgical tools into the abdominal cavity, as well as having theadditional disadvantages of being very large, very expensive,unavailable in most hospitals, and having limited sensory and mobilitycapabilities.

There is a need in the art for improved surgical methods, systems, anddevices.

BRIEF SUMMARY OF THE INVENTION

Discussed herein are various surgical end effectors—including certaincauterizing end effectors and certain dual end effectors—for use insurgical devices, including robotic in vivo devices.

In Example 1, an in vivo vessel sealing device comprises a device bodyand a bipolar vessel cautery component operably coupled to the devicebody. The device body has a cautery component actuation motor, a cuttingcomponent actuation motor, a jaw actuation motor, and a cauterycomponent shaft disposed within the body and operably coupled to the jawactuation motor. The cautery component has a stationary jaw coupled to adistal end of the cautery component shaft, a mobile jaw pivotallycoupled to the distal end of the cautery component shaft, and a cuttingcomponent operably coupled to the cutting component actuation motor. Inaddition, the cautery component is operably coupled to the cauterycomponent actuation motor.

Example 2 relates to the sealing device according to Example 1, whereinthe cautery component is rotatable about an axis parallel with theshaft.

Example 3 relates to the sealing device according to Example 1, whereinthe overall length of the device body is under about 3 inches.

Example 4 relates to the sealing device of Example 1, wherein theoverall length of the cautery component is under about 1.5 inches.

Example 5 relates to the sealing device of Example 1, wherein the deviceis an end effector coupled to an arm of an in vivo robotic device.

Example 6 relates to an in vivo robotic device comprising a device bodyoperably coupled to at least one arm, wherein the sealing device ofExample 1 is operably coupled to the at least one arm.

In Example 7, a method of cauterizing tissue of a patient with an invivo cautery device comprises positioning an in vivo cautery device nearthe tissue, positioning a cautery component rotationally in relation tothe tissue with a cautery component actuation motor, and opening amobile jaw with a jaw actuation motor and positioning the cauterycomponent such that the tissue is positioned between the mobile andstationary jaws. The method further comprises closing the mobile jawwith a jaw actuation motor, applying an electrical current to the tissuevia the mobile and stationary jaws, thereby cauterizing the tissue, andurging the cutting component in a distal direction with the cuttingcomponent actuation motor, thereby cutting the cauterized tissuepositioned between the mobile and stationary jaws.

In Example 8, an operational component for an in vivo surgical devicecomprises an actuator housing comprising at least one actuator; and anend effector housing operably coupled to the actuator housing. The endeffector housing comprises a first end effector rotationally coupled tothe end effector housing and a second end effector rotationally coupledto the end effector housing.

While multiple embodiments are disclosed, still other embodiments of thepresent invention will become apparent to those skilled in the art fromthe following detailed description, which shows and describesillustrative embodiments of the invention. As will be realized, theinvention is capable of modifications in various obvious aspects, allwithout departing from the spirit and scope of the present invention.Accordingly, the drawings and detailed description are to be regarded asillustrative in nature and not restrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a perspective view of a vessel sealing device, according toone embodiment.

FIG. 1B is a front view of a vessel sealing device, according to oneembodiment.

FIG. 1C is a side view of a vessel sealing device, according to oneembodiment.

FIG. 2 is a side view of a vessel sealing device longitudinallysectioned to show component staging, according to one embodiment.

FIG. 3A is a perspective view of a vessel sealing device with theexterior shown transparent to reveal inner components, according to oneembodiment.

FIG. 3B is a front view of a vessel sealing device with the exteriorshown transparent to reveal inner components, according to oneembodiment.

FIG. 4 is a side view of a vessel sealing device longitudinallysectioned to show inner components, according to one embodiment.

FIG. 5 is a perspective view of a vessel sealing device laterallysectioned to show inner components, according to one embodiment.

FIG. 6 is a view of a mobile jaw for a vessel sealing device in theclosed position (top), partially open position (middle), and fully openposition (bottom), according to one embodiment.

FIG. 7 is a side view of a mobile jaw (top) and an outer shell (bottom)for a vessel sealing device, according to one embodiment.

FIG. 8A is a perspective top view of a medical device with a dual endeffector component in a first orientation, according to one embodiment.

FIG. 8B is a perspective side view of the device and component of FIG.8A in a first orientation.

FIG. 9A is a perspective top view of the device and component of FIG. 8Ain a second orientation.

FIG. 9B is a perspective side view of the device and component of FIG.8A in a second orientation.

FIGS. 10A and 10B are schematic representations of the bi-directionalrange of motion of the component of FIG. 8A.

FIGS. 11A and 11B are perspective isometric views of the component ofFIG. 8A.

FIGS. 12A and 12B are perspective side views of the component of FIG.8A.

FIGS. 13A and 13B are perspective front views of the component of FIG.8A.

FIG. 14 is a perspective front view of the component of FIG. 8A.

FIG. 15 is a perspective top view of the component of FIG. 8A.

FIG. 16 is a perspective side view of the component of FIG. 8A.

FIG. 17 is a perspective isometric view of the component of FIG. 8A.

FIG. 18 is a perspective front view of the component of FIG. 8A.

FIG. 19 is a perspective front view of the component of FIG. 8A.

FIG. 20 is a perspective isometric view of the component of FIG. 8A.

FIG. 21 is a perspective side view of the component of FIG. 8A.

FIG. 22 is a perspective isometric view of the component of FIG. 8A.

FIG. 23A is a perspective view of a robotic surgical device, accordingto one embodiment.

FIG. 23B is a side view of the robotic surgical device of FIG. 23A.

FIG. 24A is a front view of a robotic surgical device, according toanother embodiment.

FIG. 24B is a perspective view of the robotic surgical device of FIG.24A.

FIG. 25A is a perspective view of a robotic surgical device positionedin a patient's peritoneal cavity, according to one embodiment.

FIG. 25B is another perspective view of the robotic surgical device ofFIG. 25A.

FIG. 25C is a perspective view of the robotic surgical device of FIG.25A.

FIG. 26A is a front perspective view of a robotic surgical device,according to a further embodiment.

FIG. 26B is a side view of the robotic surgical device of FIG. 26A beinginserted into a patient's body cavity, according to one embodiment.

FIG. 26C is a side view of the robotic surgical device of FIG. 26A beinginserted into a patient's body cavity, according to one embodiment.

FIG. 26D is a side view of the robotic surgical device of FIG. 26Apositioned a patient's body cavity, according to one embodiment.

DETAILED DESCRIPTION

The various systems and devices disclosed herein relate to devices foruse in medical procedures and systems. More specifically, variousembodiments relate to end effector devices that can be used in variousprocedural devices and systems. For example, certain embodiments relateto vessel sealing end effector devices, while other embodiments relateto dual end effector components incorporated into or used with roboticand/or in vivo medical devices. The term “dual end effector” as usedherein shall mean an operational component having two or moreinterchangeable end effectors.

It is understood that the various embodiments of end effector devices orcomponents disclosed herein can be incorporated into or used with anyother known medical devices, systems and methods, including, but notlimited to, robotic or in vivo devices as defined herein.

For example, the various embodiments disclosed herein can beincorporated into or used with any of the medical devices disclosed incopending U.S. application Ser. No. 11/932,441 (filed on Oct. 31, 2007and entitled “Robot for Surgical Applications”), Ser. No. 11/695,944(filed on Apr. 3, 2007 and entitled “Robot for Surgical Applications”),Ser. No. 11/947,097 (filed on Nov. 27, 2007 and entitled “RoboticDevices with Agent Delivery Components and Related Methods), Ser. No.11/932,516 (filed on Oct. 31, 2007 and entitled “Robot for SurgicalApplications”), Ser. No. 11/766,683 (filed on Jun. 21, 2007 and entitled“Magnetically Coupleable Robotic Devices and Related Methods”), Ser. No.11/766,720 (filed on Jun. 21, 2007 and entitled “Magnetically CoupleableSurgical Robotic Devices and Related Methods”), Ser. No. 11/966,741(filed on Dec. 28, 2007 and entitled “Methods, Systems, and Devices forSurgical Visualization and Device Manipulation”), Ser. No. 12/171,413(filed on Jul. 11, 2008 and entitled “Methods and Systems of Actuationin Robotic Devices”), Ser. No. 12/192,663 (filed on Aug. 15, 2008 andentitled “Medical Inflation, Attachment, and Delivery Devices andRelated Methods”), Ser. No. 12/192,779 (filed Aug. 15, 2008 and entitled“Modular and Cooperative Medical Devices and Related Systems”), Ser. No.12/324,364 (filed Nov. 26, 2008 and entitled “MultifunctionalOperational Component for Robotic Devices”), 61/030,588 (filed on Feb.22, 2008 and entitled Medical Devices having a Positionable Camera),Ser. No. 12/971,917 (filed on Dec. 17, 2010 and entitled “Modular andCooperative Medical Devices and Related Systems and Methods”),61/506,384 (filed on Jul. 11, 2011 and entitled “Robotic SurgicalDevices, Systems, and Related Methods”), 61/542,543 (filed on Oct. 3,2011 and entitled “Robotic Surgical Devices, Systems, and RelatedMethods”), 61/584,947 (filed on Jan. 10, 2012 and entitled “Methods,Systems, and Devices, for Surgical Access and Insertion”), and61/640,879 (filed on May 1, 2012 and entitled “Single Site RoboticDevice and Related Systems and Methods”), all of which are herebyincorporated herein by reference in their entireties.

In accordance with certain exemplary embodiments, any of the variousembodiments disclosed herein can be incorporated into or used with anatural orifice translumenal endoscopic surgical device, such as a NOTESdevice. Those skilled in the art will appreciate and understand thatvarious combinations of features are available including the featuresdisclosed herein together with features known in the art.

Certain device implementations disclosed in the applications listedabove can be positioned within a body cavity of a patient, includingcertain devices that can be positioned against or substantially adjacentto an interior cavity wall, and related systems. An “in vivo device” asused herein means any device that can be positioned, operated, orcontrolled at least in part by a user while being positioned within abody cavity of a patient, including any device that is positionedsubstantially against or adjacent to a wall of a body cavity of apatient, further including any such device that is internally actuated(having no external source of motive force), and additionally includingany device that may be used laparoscopically or endoscopically during asurgical procedure. As used herein, the terms “robot,” and “roboticdevice” shall refer to any device that can perform a task eitherautomatically or in response to a command.

Further, the various end effector embodiments could be incorporated intovarious robotic medical device systems that are actuated externally,such as those available from Apollo Endosurgery, Inc., Hansen Medical,Inc., Intuitive Surgical, Inc., and other similar systems, such as anyof the devices disclosed in the applications that are incorporatedherein elsewhere in this application.

Certain embodiments disclosed herein relate to end effector devices foruse in sealing vessels, including certain embodiments used incombination with any of the various procedural device embodimentsdescribed above. One such embodiment is a cautery device. FIGS. 1A-1Cdepict one embodiment of a cautery device 10 having a proximal end 30and a distal end 40. In the cautery device 10 depicted in FIGS. 1A-1C,the device 10 includes a body 20 with a bipolar cautery component 12 atthe distal end 40.

Known minimally-invasive in vivo cautery devices use a monopolar hookcautery component. In contrast, the embodiments disclosed herein providea different device that cauterizes and cuts vessels with more precisionand with reduced damage to the surrounding tissue.

As best shown in FIGS. 1A-1C, the bipolar cautery component 12, alsotermed a “cautery end effector” herein, includes a stationary jawcomponent 14, a mobile jaw component 16 for clasping and cauterizing avessel (e.g., a vein or artery), and a cutting component 18 for cuttingthe cauterized vessel, thus providing a three function end effector 12.The stationary jaw component 14 and mobile jaw component 16 arestructured like a pair of jaws, with the stationary jaw component 14being configured to remain stationary during the cautery process,providing a substantially rigid and stable base to support a vessel. Themobile jaw component 16 is configured such that it can move in ajaw-like fashion in relation to the stationary jaw component 14 suchthat the mobile jaw component 16 can ultimately make contact with thevessel positioned between the stationary jaw component 14 and the mobilejaw component 16 to clasp the vessel between the jaws 14, 16.

As best shown in FIGS. 6 and 7 , according to one embodiment, the mobilejaw 16 additionally includes a pivot component 13 that that projectslaterally from the proximal end of mobile jaw 16 and includes areceptacle 13 a for receiving a pin 13 b. The pivot component 13 isgenerally peg- or wedge-shaped to fit through an opening in outer shell15 and facilitates movement of mobile jaw 16 as described herein below.Stationary jaw 14 includes an opening 14 a configured to align withreceptacle 13 and receive pin 13 b.

Returning to FIGS. 1A-1C, each of the fixed jaw component 14 and mobilejaw component 16 is connected to a source of electrical current (notshown) such that the jaws 14, 16 function as bipolar electrodes, withone jaw functioning as a cathode and one jaw functioning as an anodewhen an electric current is applied. In certain implementations, thesource for electrical current is a generator (not shown) that providescurrent separately from electricity powering the motors. In someembodiments, the generator is located outside of device 10 as a separatecomponent. In use, the electricity flowing through the jaws 14, 16creates heat which cauterizes a vessel clasped between the jaws 14, 16.In some embodiments, the current is applied discretely by the operatorby, for example, pressing a button or flipping a switch on thegenerator.

As best shown in FIG. 4 , the stationary jaw 14 of the bipolar cauteryend effector 12 is attached to a shaft 32 that extends proximally fromthe stationary jaw 14 and is disposed within the body 20. The cuttingcomponent 18 is positioned between the jaws 14, 16 (as shown in FIGS.1A-1C and 4 ) and extends through the shaft 32. The shaft 32 has a slot39 cut into either or both the top 34 or bottom 36 sides of the shaft 32and extending longitudinally along part of the length of the shaft 32 toaccommodate a pin 38 (as shown in FIG. 4 ) that extends through the slot39 and attaches to or extends through the cutting component 18 such thatthe pin is coupled to the cutting component. As such, the pin 38 andcutting component 18 can slide together along the slot 39 from agenerally proximal first position to a more distal second position alongwith the cutting component 18. In some embodiments as best shown in FIG.5 , one or both of the stationary jaw 14 and mobile jaw 16 have achannel 26, 28 within which the cutting component 18 moves from thefirst position to the second position.

In the embodiment illustrated in FIG. 4 , the cutting component 18 issubstantially elongate and has a proximal end 24 and a distal end 25.The cutting component 18 includes a cutting surface 22 at the distal end25 such that when the cutting component 18 is moved from the generallyproximal first position to the more distal second position, thecauterized vessel enclosed between the jaws 14, 16 of the cautery device10 is cut at the point of cautery.

For ease of description and understanding, the cautery device 10 asdescribed herein has three sections 100, 200, 300, as illustrated inFIG. 2 . In this embodiment, each section generally defines a pluralityof components configured to control a function of the cautery device 10within the body 20. As such, the first section 100 controls theapplication of the electrical current to the jaws 14, 16 as describedabove and rotation of the bipolar cautery end effector 12. The secondsection 200 controls positioning of the cutting component 18. Finally,the third section 300 controls opening and closing of the jaws 14, 16 ofthe bipolar cautery end effector 12. It is to be understood that whilethe illustrated embodiments utilize three sections, this identificationand division of sections is provided solely for ease of description andunderstanding. It is also understood that the sections may be combinedor split into more or fewer sections. For example, the first section 100may be split into two sections separately controlling electrical currentand end effector rotation.

According to some embodiments, the sections are configured andpositioned such that the first section 100 is proximal to the bipolarcautery end effector 12, while the third section 300 is located closestto the proximal end 30 of the device 10, with the second section 200being located between the first and third sections 100, 300. In someembodiments, the sections are configured and positioned such that theshape of the cautery device 10 becomes more slender toward the distalend. It is to be understood, however, that the sections may beconfigured or positioned in any manner suitable for proper function ofthe device, and may include any modifications that provide functional,aesthetic, and/or manufacturing advantages. Such advantages include,without limitation, visibility of the bipolar cautery end effector 12,size reduction, reduced materials costs, and the like.

Power for the various functions of the device 10 as described herein isprovided by the motors 102, 202, 302, as best shown in FIGS. 4 and 5 .Electrical current for the motors 102, 202, 302 is provided by anelectrical source (not shown). According to one implementation, theelectrical source is positioned externally in relation to the device 10.Alternatively, the electrical source can be positioned within thedevice. In some embodiments, the source of electricity for motors 102,202, 302 also includes a control device (not shown) that includescomponents for controlling the motors 102, 202, 302 and/or sensing thestatus (e.g., position) of motors 102, 202, 302. For example, thecontrol device could be an external control device configured to bemanipulated by a user. In some embodiments, the source of electriccurrent for motors 102, 202, 302 is separate from the control device. Inother embodiments, each motor 102, 202, 302, is controlled and/orpowered separately from one another. In some embodiments, theelectricity for motors 102, 202, 302 is provided by the same electricitysource as the current provided to jaws 14, 16.

As best shown in FIG. 5 , one or more of motors 102, 202, 302 have anencoder, e.g., 102 a, 302 a, (not shown for motor 202), which isconnected to the control device for receiving control instructions fromthe control device and providing data about the status of motors 102,202, 302 to the control device. In some embodiments, one or more motors102, 202, 302 also have a gear head, e.g., 102 b, 302 b, (not shown formotor 202). The gear heads 102 b, 302 b, (not shown for motor 202) canbe fixed or, in some embodiments, removable and interchangeable toprovide multiple gear ratios.

In accordance with one implementation, due to the electrical nature ofthe bipolar cautery end effector 12, the drivetrain—including the first100, second 200, and third 300 sections of the device—is electricallyisolated from the motors 102, 202, 302 through the use of non-conductivegears driven by the motors 102, 202, 302. In one embodiment, thenon-conductive gears are made of nylon. Alternatively, the gears can bemade of any known non-conductive material that can be used in gears. Thenon-conductive gears inhibit electrical current from flowing through thedrive train to the jaws 14, 16 and producing electrical interferencethat affects communication between the motors 102, 202, 302 and controldevice. In some embodiments, both conductive and non-conductive gearsare used. For example, in one implementation, as best shown in FIGS. 4and 5 , gears 106, 208, 306 are made of non-conductive material, whilegears 104, 206, 308 are made of a conductive material. In accordancewith another implementation, the effect of electrical interference canbe reduced through the use of interference-reducing software and/orcomponents in the control device or encoder 102 a, 302 a instead of, orin addition to, the use of non-conductive gears.

As best shown in FIGS. 3A and 5 , the first section 100 of the cauterydevice 10 includes a first section motor 102 that is operatively coupledto the bipolar cautery end effector 12 to control rotation of thebipolar cautery end effector 12. In some embodiments, the first sectionmotor 102 is directly coupled to the bipolar cautery end effector 12 orcan be indirectly coupled to the bipolar cautery end effector 12 by oneor more coupling means. For example, in the embodiment illustrated inFIGS. 3A and 3B, the first section motor 102 is coupled to the bipolarcautery end effector 12 by a first gear 104 and a second gear 106, thesecond gear 106 being attached to the shaft 32 of the bipolar cauteryend effector 12 via metal coupler 108, as best shown in FIG. 5 , suchthat rotational movement produced by the first section motor 102 istransferred to rotational movement of the bipolar cautery end effector12 around axis A depicted in FIG. 3A. In some embodiments, metal coupler108 is coupled to the bipolar cautery end effector 12 via an outer shell15. As best shown in FIGS. 6 and 7 , outer shell 15 projects distallyfrom the metal coupler 108 and includes an opening 15 a through whichpivot component 13 on mobile jaw 16 projects and translates rotationalmovement of coupler 108 to shaft 32.

Second gear 106 can be fixed to the metal coupler 108 using, forexample, an adhesive (e.g., UV cure glue). In some embodiments, thesecond gear 106 and the metal coupler 108 are configured such that theshape of each component prevents the second gear 106 from movingrelative to the metal coupler 108 (i.e., non-circular geometry). Forexample, the metal coupler 108 can be generally square-shaped to fitinto a generally square-shaped hole in the second gear 106.

Returning to FIG. 4 , the first section 100 additionally includescomponents for applying electrical current to the jaws 14, 16. In thisembodiment, the first section 100 includes an electrical connection 110for the mobile jaw 16. The electrical connection 110 is configured toallow sliding contact to a first slip ring 112, which is connected to asource of electrical current (not shown) either directly or indirectly.Slip ring 112 is generally U-shaped or C-shaped such that it maintainscontact with electrical connection 110 when electrical connection 110rotates with shaft 36. The use of slip ring 112 rather than a wire toprovide electrical connection to connection 110 prevents twisting ofwires about the drive train as connection 110 rotates. Mobile jaw 16 iselectrically connected to connection 110 via a conductor, such as wire13 c shown in FIG. 7 or other appropriate conductor. Electricalconnection 110 is electrically isolated from stationary jaw 14 by theinclusion of a non-conductive (e.g., plastic) ring 17 between theconnection 110 and the stationary jaw 14. The first section alsoincludes a second slip ring 114 associated with the stationary jaw 14,that functions similarly to the first slip ring 112 by maintainingelectrical contact with shaft 36 during rotation. The use of slip rings112, 114 to separately provide current to jaws 16, 14, respectively,allows one jaw to function as a cathode and one jaw to function as ananode when an electric current is applied. In some embodiments, it maybe desirable to include additional components or modifications to limitor focus electrical communication between jaws 14, 16.

The second section 200 in the embodiment shown in FIG. 4 includes asecond section motor 202 that is operatively coupled to the cuttingcomponent 18 to control movement of the cutting component 18 from afirst position to a second position along line of movement M. The secondsection motor 202 is coupled to a threaded collar 204 either directly orindirectly via a coupling means. In the embodiment illustrated in FIG. 4, the coupling means for coupling the second section motor 202 to thethreaded collar 204 includes a first gear 206 connecting the secondsection motor 202 to a second gear 208, the second gear 208 beingattached to the threaded collar 204 using, for example, an adhesive(e.g., UV cure glue) or non-circular geometry, as described above. Anend of the pin 38 attached to or extending through the cutting component18 is seated in a thread 212 of the threaded collar 204 such thatrotational movement produced by the second section motor 202 istranslated to lateral movement of the pin 38 along M and thereby thecutting component 18. The second section is configured such that themovement of the cutting component 18 along M is a distance ranging fromabout 0.5 to about 1.0 inches in order to cut a vessel clasped betweenjaws 14, 16. Alternatively, the distance ranges from about 0.7 inches toabout 1.0 inches. However, the distance can be adjusted as appropriatefor the vessel size and specific configuration of the cautery device 10.In one embodiment, the pivot component 13 of mobile jaw 16 includes anopening through which the cutting component 18 passes when moved. Whennot being used to cut a vessel, the cutting component 18 is retracted toa position proximal to the jaws 14, 16 such that the mobile jaw 16 maybe opened or closed.

The third section 300 illustrated in FIGS. 4 and 5 includes a thirdsection motor 302 that is operatively coupled to mobile jaw 16 tocontrol opening and closing of the jaws 14, 16. In some embodiments, thethird section motor 302 is directly coupled to shaft 32 or can beindirectly coupled to shaft 32 by one or more coupling means. Forexample, in the embodiment illustrated in FIGS. 4 and 5 , the thirdsection motor 302 is coupled to the shaft 32 by a first gear 308 and asecond gear 306, the second gear 306 being attached to collar 310 using,for example, an adhesive (e.g., UV cure glue) or non-circular geometry.In some embodiments, the shaft 32 and collar 310 are threaded such thatrotation produced by motor 302 is translated to lateral movement of theshaft 32 along M and thereby the jaws 14, 16 relative to outer shell 15.As best seen in FIG. 6 , opening 15 a restricts lateral movement ofpivot component 13 of mobile jaw 16 along M relative to outer shell 15such that lateral translation of shaft 32 along M causes mobile jaw 16to open or close by pivoting around pin 13 b via the pivot component 13at opening 15 a.

In an alternative embodiment, stationary jaw 14 can be replaced with asecond mobile jaw. In this embodiment, the second mobile jaw ispivotably attached to shaft 32 and includes a pivot component similar topivot component 13. In this embodiment, outer shell 15 is configured toinclude a second opening similar to opening 15 a that restricts lateralmovement of the pivot component of the second mobile jaw such that thesecond mobile jaw is opened and closed via translation of shaft 32 alongM in a manner similar to mobile jaw 16.

The third section 300 can further include a means for detecting thethickness of a vessel clasped between the jaws 14, 16. Vessel thicknesscan be calculated, for example, based on the amount of lateraltranslation of shaft 32 along M required to close mobile jaw 16 or theposition of mobile jaw 16 relative to stationary jaw 14. In someembodiments, the position of mobile jaw 16 relative to stationary jaw 14is determined for example, by measuring electrical impedance betweenjaws 14, 16.

As discussed above, the cautery device embodiments disclosed herein canbe utilized in any type of medical device, including those devices inwhich a compact or smaller size is desirable, such as devices forprocedures to be performed within a patient. In order to achieve acautery device with appropriate dimensions for such use, the dimensionsof components disclosed herein can be adjusted to control the overallsize of the device. For example, in one implementation, the motors 102,202, 302 can range in size from about 8 mm to about 15 mm, while theoverall length of the body is kept under about 3 inches. In someembodiments, the overall length of the cautery component is kept underabout 1.5 inches. In some embodiments, the height and/or width is keptunder 2 inches. Alternatively, other dimensions can be used depending onsize, weight, and/or visibility requirements.

In use, the cautery device 20 is positioned next to the target vesselusing a complementary system or device as described elsewhere such as anarticulating robotic arm. Next, the cautery device 20 operates in thefollowing manner to cauterize the vessel. The first section motor 102rotates the cautery end effector 12 to position the jaws 14, 16 in analignment with the vessel such that the jaws may enclose the vessel. Thethird section motor 302 actuates the mobile jaw 16 to open and thecautery end effector 12 is positioned such that the vessel is locatedbetween the jaws 14, 16. The third section motor 302 then actuates themobile jaw 16 to close with the vessel disposed between the jaws 14, 16and the source of electrical current (not shown) applies an electriccurrent to the vessel via the jaws 14, 16, thereby cauterizing it. Thesecond section motor 202 drives the cutting component 18 toward thedistal end of the cautery device 20 and thus pushes the cutting surface22 through the vessel enclosed in the jaws 14, 16, thereby cutting thevessel.

FIGS. 8A-22 depict a dual end effector operational component 410 thatcan be incorporated into any one of a variety of medical devices asdescribed above. In this embodiment, the dual end effector operationalcomponent 410 is positioned on the end of a robotic arm 412. It isfurther understood that the robotic arm 412 can be part of any roboticmedical device, such as an in vivo device. As best shown in FIGS.8A-10B, the arm 412 has two arm segments, including a first arm segment(or “upper arm”) 412A and a second arm segment (or “forearm”) 412B. Thefirst arm segment 412A is rotatably coupled with a torso motor housing414 via a joint or hinge (not shown). The torso motor housing 414 housesa motor and actuation mechanism (not shown) to provide rotation of thefirst arm segment 412A relative to the torso motor housing 414. Further,the first arm segment 412A is rotatably coupled to the second armsegment 412B at joint 416A, while the second arm segment 412B isrotatably coupled to the dual end effector operational component 410 atjoint 416B.

In one embodiment, the dual end effector operational component 410 hasan actuator housing 418 and an end effector housing 420. The endeffector housing 420 has two end effector elements 422, 424. In theembodiment depicted in FIGS. 8A-10B, one end effector element is acautery component 422 and the second end effector element is a grasper424. Alternatively, the end effector elements on the dual end effectoroperational component 410 can be any known end effectors for use withmedical devices, such as, for example, forceps, needle drivers,scissors, Ligasure™, or knife components, to list a few.

As best shown in FIGS. 8A and 8B, in one embodiment, although both endeffector elements 422, 424 remain operable, the end effector housing 420is oriented so that the grasper 424 is accessible to the subject tissueand can perform a medical procedure.

As best shown in FIGS. 9A and 9B, in another embodiment, although bothend effector elements 422, 424 remain operable, the end effector housing420 is oriented so that the cautery component 422 is accessible to thesubject tissue and can perform a medical procedure.

In one embodiment, both end effector elements 422, 424 can rotate inrelation to the end effector housing 420. More specifically, as bestshown in FIG. 9A, the cautery component 422 is rotatable relative to theend effector housing 420 as shown by arrow AA around an axis indicatedby line A. Further, the grasper 424 is rotatable relative to the endeffector housing 420 as shown by arrow BB around an axis indicated byline B. According to one embodiment, the grasper 424 is also configuredto move between an open configuration and a closed configuration (notshown). In an alternative embodiment (not shown), both end effectorelements 422, 424 can rotate relative to the end effector housing 420and also can be configured to move between an open configuration and aclosed configuration, depending on the type of end effectors. In anotheralternative embodiment, the two end effectors can be operably coupled toeach other such that both end effectors can be configured to movebetween open and closed positions.

As best shown in FIG. 10A, in one embodiment, the dual end effectoroperational component 410 can be rotated relative to the second armsegment 412B via the joint 416B and an actuation motor and gear system(not shown) contained within the second arm segment 412B.

As best shown in FIG. 10B, in one embodiment, the dual end effectoroperational component 410 and the second arm segment 412B can be rotatedrelative to the first arm segment 412A via the joint 416A and anactuation motor and gear system (not shown) within the first arm segment412A.

As best shown in FIGS. 11A-12B, within the dual end effector 410, theforearm gear housing 426 contains an actuation motor 428 that is rigidlycoupled to a driveshaft 430. The driveshaft 430 is rigidly coupled to arotational motor spur gear 432. The rotational motor spur gear 432 isrotatably coupled to a rotational gear 434 that is rigidly coupled tothe second arm segment (such as, for example, the second arm segment412B as shown in FIGS. 8A-10B). Actuation of the actuation motor 428causes rotation of the driveshaft 430 and the rotational motor spur gear432. Rotation of the rotational motor spur gear 432 causes rotation ofthe dual end effector operational component 410 relative to the secondarm segment (such as second arm segment 412B).

As best shown in FIGS. 13A and 13B, in one embodiment, the cauterycomponent 422 has a proximal cautery housing 436 rigidly attached to adistal cautery tip 438. In one embodiment, the wire (not shown)supplying electricity to the cautery tip 438 is enclosed in the cauteryhousing 436. The wire runs proximally through the dual end effectoroperational component 410 and is coupled at a proximal end of the wireto a power source such as a standard electrocautery generator (notshown). In another embodiment, the power source could be located withinthe dual end effector operational component 410. According to theimplementation as shown, the grasper 424 has a proximal grasper housing440 coupled to two grasping elements 442, 444.

As best shown in FIG. 13B, in one embodiment, the cautery housing 436 isrigidly coupled to a cautery rotational gear 446 within the end effectorhousing 420. Further, the grasper housing 440 is rigidly connected tothe grasper rotational spur gear 448 within the end effector housing420.

As best shown in FIG. 14 , the cautery rotational gear 446 is rotatablycoupled with a rotational motor spur gear 450. The rotational motor spurgear 450 is rotatably actuated by a rotational motor 452 and arotational motor gearhead 454 coupled to the motor 452. Actuation of therotational motor 452 and rotational motor gearhead 454 causes rotationof the rotational motor spur gear 450, and thus the cautery rotationalgear 446 and the cautery housing 436. The cautery housing 436 is furthercoupled to two bearing elements 456, 458 proximal to the cauteryrotational gear 446: a distal bearing 456 and a proximal bearing 458,both of which support the cautery housing 436 and reduce rotationalfriction thereof. The cautery housing 436 and proximal bearing 458 arefurther coupled to a cautery housing preload nut 460 that limitstranslation of the cautery housing 436 and provides a preload orclamping force for the two bearing elements 456, 458 to aid in reducingfriction during rotation of the cautery housing 436 by holding thebearing elements 456, 458 in place during rotation.

In one embodiment, the grasper rotational spur gear 448 is rotatablycoupled with the rotational motor spur gear 450. Actuation of therotational motor 452 and rotational motor gearhead 454 causes rotationof the rotational motor spur gear 450, and thus causes rotation of thegrasper rotational spur gear 448 and the grasper housing 440simultaneously with rotation of the cautery housing 436.

In one embodiment, proximal to the grasper rotational spur gear 448, thegrasper housing 440 is coupled to two beveled washer elements—a distalbeveled washer element 462 and a proximal beveled washer element464—that provide compliance for the grasper and prevent contact betweenmoving parts during rotation of the grasper housing 440. The grasperhousing 440 is further coupled to two bearing elements—a distal bearing466 and a proximal bearing 468—that provide support for and reducerotational friction of the grasper housing 440. The grasper housing 440is further coupled to a distal hex preload nut 470 that limitstranslation of the grasper housing 440 and provides a preload orclamping force for the bearings 466, 468 to help reduce friction duringrotation of the grasper housing 440 by holding the bearings 466, 468 inplace during rotation.

In one embodiment, an actuation motor 472 is rigidly coupled to anactuation motor housing 474 by two actuation motor mounting bolts 476,478. The actuation motor mounting bolts 476, 478 constrains thetranslation and rotation motion of the actuation motor 472 to theactuation motor housing 474.

As best shown in FIG. 15 , in one embodiment, the actuation motor 472 isrigidly coupled to the actuation motor spur gear 480. Actuation of theactuation motor 472 causes rotation of the actuation motor spur gear 480and this rotation is translated to the driveshaft housing spur gear 482.

As best shown in FIG. 16 , the driveshaft housing spur gear 482 isrigidly coupled to the driveshaft housing 484 which is, in turn,rotatably coupled to the grasper driveshaft 486. Rotation of thedriveshaft housing spur gear 482 via actuation of the actuation motor472 and the actuation motor spur gear 480 therefore results in rotationof the driveshaft housing 484. Rotation of the driveshaft housing 484 inturn causes translation of the grasper driveshaft 486.

In one embodiment, rotation of the driveshaft housing 484 is aided by aproximal hex preload nut 488, several beveled washer elements 490, 492,494 and bearing elements 496, 498. The driveshaft housing 484 is furtherrigidly coupled to a driveshaft housing screw 500 that constrainstranslation of the driveshaft housing 484 to the proximal bearing 498.

As best shown in FIG. 17 , a grasper rotational pin 502 is threadedthrough one side of the grasper housing 440, through a hole in each ofthe grasping elements 442, 444 and is rigidly coupled on the oppositeside of the grasper housing 440. As the grasper driveshaft 486 istranslated via rotation of the driveshaft housing 484 (as best shown inFIG. 16 ), a connector pin 504 that connects the grasper driveshaft 486to the grasper elements 442, 444 slides up and down in the grooves ofthe grasper elements 442, 444. This translation in turn causes thegrasper elements 442, 444 to open and close.

As best shown in FIGS. 18 and 19 , the cautery component 422 can extendand retract as necessary for operation and accessibility of the desiredend effector element. As best shown in FIG. 18 , the cautery component422 can be retracted through retraction of the retractable cautery shaft506 during operation of the grasper 424 so that unwanted contact withtissue by the cautery component 422 can be avoided. As best shown inFIG. 19 , during operation of the cautery component 422, the cauterycomponent 422 can be extended beyond the proximal tip of the grasper 424by extension of the retractable cautery shaft 506.

As best shown in FIGS. 20 and 21 , the cautery component 422 is extendedand retracted through rotation of the rotational motor spur gear 450.The rotational motor spur gear 450 is rotatably coupled to the upperlong cautery shaft 508. The upper long cautery shaft 508 is rigidlycoupled to the lower long cautery shaft 510 via a set screw 512. Thelower long cautery shaft 510 is supported by two bearing elements 514,516. The lower long cautery shaft 510 is rotatably coupled to theretractable cautery shaft 506.

As best shown in FIG. 22 , rotation of the lower long cautery shaft 510(depicted in FIGS. 20 and 21 ) causes the retractable cautery shaft 506to retract or extend via external threading on the retractable cauteryshaft 506 and internal threading on the threaded cautery energizing ring518. The external threading of the retractable cautery shaft 506 causesthe retractable cautery shaft 506 to translate up and down when thelower long cautery shaft 510 (depicted in FIGS. 20 and 21 ) is rotated.Power is supplied to the cautery component 422 via a wire (not shown)connected to the energizing ring 518.

As discussed above, the various embodiments disclosed herein relate toend effector devices that can be incorporated into any of the medicaldevices, including robotic and/or in vivo device, disclosed in thevarious patents and applications incorporated by reference above.Further, as also discussed above, the various implementations can bepositioned on the end of a robotic arm.

For example, any of the embodiments disclosed herein can be incorporatedinto the robotic device embodiments disclosed in U.S. Pat. No. 8,679,096(which was incorporated herein above), including the devices depicted inFIGS. 23A-24B. FIGS. 23A and 23B depict a combination or modular medicaldevice 600 having three modular components 602, 604, 606 coupled orattached to each other. More specifically, the device 600 has tworobotic arm modular components 602, 604 and one robotic camera modularcomponent 606 disposed between the other two components 602, 604. Eachof the modular arm components 602, 604 have arms 608, 610. FIGS. 24A and24B depict a robotic device 620 according to a further embodiment inwhich the device 620 has two arms 622, 624, each having a first link622A, 624A and a second link 622B, 624B. Each arm 622, 624 also includesoperational components 626, 628 that can be the same or different fromone another. In addition, the device 620 has a body 630 that can havelighting and/or camera components and is disposed between and coupled toboth arms 622, 624 as shown.

As another example, the various embodiments disclosed herein can also beincorporated into the robotic device embodiments disclosed in U.S.Application 61/506,384 (which was incorporated herein above), includingthe device shown in FIGS. 25A-25C. FIG. 25C depicts a robotic device 700having a body 702 having two components 702A, 702B, wherein the body 702is coupled to a support component 704 having a first support leg 706Aand a second support leg 706B. Body component 702A is coupled to arm708, and body component 702B is coupled to arm 710. Each of the arms708, 710 has a first joint 708A, 710A (each of which can also bereferred to as a “shoulder joint”) that is coupled to the bodycomponents 702A, 702B. Each first joint 708A, 710A is coupled to a firstlink 708B, 710B that is rotatably coupled to a second link 708C, 710C.In addition, each arm 708, 710 also has an operational component 708D,710D coupled to the second link 708C, 710C.

As best shown in FIGS. 25A and 25B, the support component 704 isconfigured to maintain the device 700 in the desired positioned within acavity 712 within the patient. The support component 704, which iscoupled to the body 702, is disposed through an orifice or any otherkind of opening in the body cavity wall 714 such that the distal portionof the component 704 coupled to the body 702 is disposed within the bodycavity 712 while the proximal portion is disposed outside the patient'sbody and can be attached to an external component (not shown) so as toprovide stability or fixed positioning for the device 700.

In a further example, the various embodiments disclosed herein can alsobe incorporated into the robotic device embodiments disclosed in U.S.Application 61/640,879 (which was incorporated herein above), includingthe device depicted in FIGS. 26A-26D. FIG. 26A depicts a robotic device800 having a main body 802, a left arm 804, and a right arm 806. Each ofthe arms 804, 806 is comprised of two segments: an upper arm (or firstlink) 804A, 806A, and a forearm (or second link) 804B, 806B, therebyresulting in each arm 804, 806 having a shoulder joint (or first joint)804C, 806C and an elbow joint (or second joint) 804D, 806D. Each arm804, 806 also has an end effector 808, 810. As shown in FIGS. 26B-26D,the device 800 can be positioned in or inserted into a cavity 820 of apatient such that, during a procedure, the arms 804, 806 are disposedentirely within the body cavity 820 while the device body 802 ispositioned through an incision 824 in the wall 822 of the cavity 820.

Although the present invention has been described with reference topreferred embodiments, persons skilled in the art will recognize thatchanges may be made in form and detail without departing from the spiritand scope of the invention.

The invention claimed is:
 1. An in-vivo vessel sealing end effector, theend effector comprising: (a) an in vivo end effector body coupleable toan arm of an in vivo robotic device, wherein the arm and the endeffector body are configured to be positioned entirely within a cavityof a patient, the end effector body comprising at least one actuator anda cautery component shaft disposed within the body; and (b) a bipolarvessel cautery component operably coupled to the end effector body, thecautery component comprising: (i) a stationary jaw disposed at a distalend of the cautery component shaft; (ii) a mobile jaw pivotally coupledto the distal end of the cautery component shaft; and (iii) a cuttingcomponent moveably coupled to the cautery component shaft, wherein theat least one actuator comprises a jaw actuator operably coupled to themobile jaw.
 2. The end effector of claim 1, wherein the cauterycomponent is rotatable about an axis parallel with the shaft.
 3. The endeffector of claim 1, wherein the overall length of the end effector bodyis under about 3 inches.
 4. The end effector of claim 1, wherein the atleast one actuator comprises a cautery component rotation actuatoroperably coupled to the cautery component shaft.
 5. The end effector ofclaim 1, wherein the at least one actuator comprises a cutting componentactuator operably coupled to the cutting component.
 6. The end effectorof claim 1, wherein the stationary jaw is configured to provide a stablebase to support a vessel to be cauterized.
 7. The end effector of claim1, wherein rotation of the cautery component shaft causes rotation ofthe mobile and stationary jaws.
 8. The end effector of claim 1, furthercomprising (a) an electrical connection disposed on the cauterycomponent shaft, wherein the electrical connection is electricallycoupled to one of the mobile jaw and the stationary jaw; (b) a firstslip ring disposed within the end effector body, wherein the first slipring is electrically coupled with the electrical connection duringrotation of the cautery component shaft; (c) a second slip ring disposedwithin the end effector body, wherein the second slip ring iselectrically coupled with the cautery component shaft during rotation ofthe cautery component shaft; and (d) an external electrical sourceelectrically coupled to the first and second slip rings.
 9. An in-vivovessel sealing end effector, the end effector comprising: (a) an in vivoend effector body coupleable to an arm of an in vivo robotic device,wherein the arm and the end effector body are configured to bepositioned entirely within a cavity of a patient, the end effector bodycomprising a cautery component shaft disposed within the body; and (b) abipolar vessel cautery component operably coupled to the end effectorbody, the cautery component comprising: (i) a stationary jaw fixedlydisposed at a distal end of the cautery component shaft; (ii) a mobilejaw pivotally coupled to the distal end of the cautery component shaft;and (iii) a cutting component moveably coupled to the cautery componentshaft.
 10. The end effector of claim 9, further comprising a threadedcollar disposed around and threadably coupled with the cautery componentshaft such that rotation of the collar causes axial movement of thecautery component shaft, thereby causing the mobile jaw to move betweenopen and closed positions.
 11. The end effector of claim 9, whereinrotation of the cautery component shaft causes rotation of the mobileand stationary jaws.
 12. The end effector of claim 9, furthercomprising: (a) a collar rotatably disposed within the end effectorbody; (b) a translation pin fixedly coupled to the cutting component andoperably coupled to the collar, such that rotation of the collar causesaxial movement of the cutting component between retracted and deployedpositions.
 13. The end effector of claim 9, further comprising: (a) anelectrical connection disposed on the cautery component shaft andelectrically coupled to one of the mobile jaw and the stationary jaw;and (b) a first slip ring disposed in the end effector body, wherein thefirst slip ring is electrically coupled with the electrical connectionduring rotation of the cautery component shaft.
 14. The end effector ofclaim 13, further comprising an external electrical source electricallycoupled to the first slip ring.
 15. The end effector of claim 13,further comprising a second slip ring disposed in the end effector body,wherein the second slip ring is electrically coupled with the cauterycomponent shaft during rotation of the cautery component shaft, whereinthe second slip ring is electrically coupled to an external electricalsource.
 16. An in-vivo vessel sealing end effector, the end effectorcomprising: (a) an in vivo end effector body coupleable to an arm of anin vivo robotic device, wherein the arm and the end effector body areconfigured to be positioned entirely within a cavity of a patient, theend effector body comprising at least one actuator and a cauterycomponent shaft disposed within the body; and (b) a bipolar vesselcautery component operably coupled to the end effector body, the cauterycomponent comprising: (i) a stationary jaw fixedly disposed at a distalend of the cautery component shaft; (ii) a mobile jaw pivotally coupledto the distal end of the cautery component shaft; and (iii) a cuttingcomponent moveably coupled to the cautery component shaft.
 17. The endeffector of claim 16, further comprising: (a) a first threaded collarrotatably disposed within the end effector body; and (b) a translationpin fixedly coupled to the cutting component and threadably coupled tothe first threaded collar, such that rotation of the first threadedcollar causes axial movement of the cutting component between retractedand deployed positions.
 18. The end effector of claim 17, furthercomprising a second threaded collar disposed around and threadablycoupled with the cautery component shaft such that rotation of thesecond collar causes axial movement of the cautery component shaft,thereby causing the mobile jaw to move between open and closedpositions.
 19. The end effector of claim 16, wherein the stationary jawis configured to provide a stable base to support a vessel to becauterized.